Health psych 383 Flashcards
Factors that modify the health impact of stress
Modifying the stressor, Modifying the person’s reaction to the stressor and modifying the relationship between stress and illness
What is Coping
Thoughts and behaviors used o manage the demands of stressful situations
Characteristics of Coping
Dynamic process between coping and stressful event, series of transactions between a person who has a set resources, values and commitments and a particular environment with its own resources and demands and constraints. Set of responses, occurring over time, by which the environment and the person influence each other. Another important aspect is its breath. Emotional reactions include anger or depression, and part of the coping process, voluntarily undertaken to confront the event
How to protect against for stressful events
Enhance social support, Improve one’s sense of personal control, organize one’s world better, preparing and planning for stressful events.
Negative affectivity
a pervasive negative mood marked by anxiety, depression, anger, and hostility; related to neuroticism
Negative affectivity is associated
with elevated cortisol secretion, HR, inflammation, etc
Disease-prone personality
Increased risk for arthritis, diabetes, kidney and liver disease, stomach and gallbladder problems, ulcers, asthma, headaches, heart disease
Type A personality
Common is cardiac patients, competitive, achievement orientation, critical of self and others, time urgency, anger/hostility. Greater stress reactivity, react more quickly and strongly
Type B personality
Low competitiveness, low time urgency, low anger/hostility
Hostility
Produces high levels of stress hormones, high levels of stress hormones puts strain on the heart (high BP and HR), injuries heart and blood vessels over time, high levels is also related to increased smoking and poor nutrition, decreased exercise.
Optimism
Report less stress and depression, more likely to seek out social support and engage in effective coping strategies. Lower BP, less susceptible to common cold, quicker healing after surgery, lower risk of heart disease.
Psychological control
The belief that one can determine one’s own behavior, influence one’s own behavior, influence one’s environment, and bring about desired outcomes.
To improve psychological control & self-efficacy
Engage in more health-promoting behaviors
Self-esteem
Associated with lower levels of cortisol and adrenocortrophic hormone in response to stress. High of this is tied to effective coping.
Personality Resources that Benefit Coping
Sense of coherence about one’s life, sense of purpose or meaning, sense of humor, trust in others, religious beliefs, conscientiousness, resilience, psychological wellness begets physical wellness
Coping style
General propensity to deal with stressful events in a particular way
Coping styles
Approach vs. avoidant
Problem focused vs, emotional-focused and emotional-approach coping
Approach vs. avoidant style
Approach style generally better for health
Problem-focused vs, emotion-focused
Problem-focused is better when the stressor can be changed; emotion-focused is better when it can’t
Emotional-approach coping
Clarifying, focusing on, and working through the emotions experienced in conjunction with stress.
Health benefits across a broad array of stressors
Teaching Coping skills includes
Mindfulness training (MBSR)
Mindfulness training (MBSR)
Systematic medication training to teach self-regulation to stress and negative emotions, strive to be highly aware and present in the moment, acknowledge and accept how things are without judging, and approach situations mindfully, not automatically, and has beneficial health effects.
Stress management includes
Self-monitoring of stress, identifying stress ancients, avoid and changing negative self-talk, completing take-home assignments, acquiring and practicing skills, setting goals and engaging in positive self-talk and self instruction
Other coping skills training
Time management skills,relaxation skills, assertiveness training, affect regulation training, problem solving training, and all effecting coping strategies require practice
Types of social support
Tangible assistance, informational support,emotional support, and invisible support.
Effects on social support on health
Decreases feeling of loneliness and psychological distress, reduces the physiological and neuroendocrine responses to stress.
Direct effects on social support
Improves immunity, lowers likelihood of contracting illness and speeds recovery
Indirect effects on social support
People with greater social support are more likely to follow doctors orders,use health services, and engage in other health behaviors
Direct effect hypothesis
Says social support is always beneficial
Buffering hypothesis
Says that social support is always beneficial during times of high stress
Matching hypothesis
If you need to borrow money and your support network can only provide emotional support, won’t be very helpful
How do people decide if their ill
Recognition of symptoms, individual differences, attention differences
Culture bound syndrome
Health problems that are culturally specific that are only recognized as a disease in a specific culture
Culture bound syndrome are characterized by
Characterized by recognition as a diseases in the culture, widespread familiarity in the culture, complete lack of familiarity to people in other cultures, no objectivity demonstrable biological or tissue abnormalities, condition is usually recognized and treating by.
Examples of culture bound syndromes are
Latah, Dhat syndrome, Ghost sickness, Hwabyung, Koro, and malde ojo malochio
Lay referral network
Members of family on social network who are asked for health information, prompters, lay community health advisors, peer health navigates often preferred modes of health, information in certain cultures and communities, very important when health care is not easily available often includes complementary and alternative medicine
Who uses health services
Age: old and very young
Gender: Women more than men
Social class and culture: lower SES is less likely to use services
Misusing health services
Seing a doctor for psychological problems, malingering, drug seeking, reinforcing aspects of being sick: secondary gains
Other misuse
Not seeking treatment when they should, appraisal delay, illness delay, behavioral delay and medical delay.
Appraisal delay
Time to decide a symptom is serious
Illness delay
Time between a symptom recognition and decision and decision to seek care
Behavioral delay
Time between deciding to seek care and doings
Medical delay
Time between making an appointment and receiving the appropriate medical care
Factors contribute to delay behavior
Perceived expense to treatment; no regular contact with physician, don’t know where to go; fear of doctors, hospitals, and medical procedures; symptoms perceived as minor or familiar, avoidance coping, procrastination and low health literacy
Poor health literacy
Strong predictor of a persons health than age etc
Health information depends on
Where you get the information, how do you know whether the info is accurate, what are some good sources of health information, how do you access those sources, and what skills do you need to use the information
World health organization of health literacy
Represents the cognitive and social skills which determine motivation and ability for individuals to gain access to, understand, and use information in ways that promote and maintain good health. Discepancy between system demands and patient capabilities/resources. Can be effected by unfamiliarity with health problem, anxiety, stress, discrimination, experience, and many other factors.
People with low health literacy are
Less likely to have health insurance, less likely to report good health, have lower health related knowledge, 1.5 to 3 times more likely to have a negative health outcome, less likely to use preventive services, screenings, physician visits, and immunizations, and more likely to use ER and be hospitalized.
People with low health literacy
More likely to be diagnosed with late stage of cancer, More likely to be non adherent to medical regimes and more likely to have medication errors and complications
People with high health literacy
More likely to have better outcomes with surgery, and more likely to take meds as prescribed.
Improving health literacy
Better education system, better health classes in school, diagnose head injuries, learning disabilities and mental health problems, Make medical care easy to understand, keep prescriptions as simple as possible, use plain language, use teach-back technique, use universal precautions, and use pics and charts as reminders.
True or false : getting to know people is like getting fish to nice the water because we don’t know anything else and culture effects everything we do
True
Pyramid of violence
Language and jokes is at the bottom includes sexism, derogatory comments, gender specific names (bitchy and pussy) and minimizes violence; rigid stereotypes such as gender, major in college and greek life; Objectification/dehumanization ex. don’t see someone as a person and name calling; discrimination includes wage gap; Victim blaming includes judging the victim on type of clothes, drinking, slutty; verbal and emotional abuse; physical abuse; sexual abuse; murder.
Verbal/ emotional abuse-murder= reactionary
affirmative control, safe houses, voice center, and police
language and jokes-> victim blaming = primary prevention
getting to the roots of the issue, voice center talks, and not in our house campaign
Bystandard intervention
the only researched, tried and true method for preventing sexual assault, making people who make inappropriate jokes/ comments realize that they are hurtful and unwelcome.
Listen, believe and support.
In all the studies discussed in class, approximately how many people ing the use had limited or inadequate health literacy
30%
health literacy and 3 components
Ability to obtain, process, and understand health information
Three consequences/ negative outcomes to health outcomes associated with low health literacy
Misuse of prescription or taking drugs, risks for disease, stress or embarrassed
Three things health care providers can do to help patients understand
Inform them about good habits, talk to them about medication they are prescribing and giving them reason to why they tell them what to do.
What are ACEs
Adverse, childhood, experiences more bad things happen during childhood. The more ACEs, the worse health later on
Patient-provider communication
Important to patients and effective care, poor communication=non adherence
Adherence is important
Blood sugar testing and control in diabetics, asthma management, HIV treatment, diet and exercise for heart disease
Health communication
Average doctor visit last 12-15 minutes, when explaining symptoms, physician will, on average, interrupt before you get 23 seconds in, provider has to extract pertinent information from extraneous information and source of frustration for many patients
Barriers to effective communication
Jargon and baby talk, depersonalization or nonperson treatment, language barriers, stereotypes of patients
Consequences of poor communication
Patient dissatisfaction, dissatisfied patient are less likely to use services in the future, dissatisfied patients are less likely to obtain checkups, more likely to change doctors, more likely to file formal complaints, poor adherence to recommendations, increased fear and anxiety related to seeking care
Nonadherence
15%-93% across all treatment regimens, antibiotics:1/3 patients fail to complete treatment, 50-60% do not keep appointments for modifying preventive health behaviors, 80% drop out of lifestyle change programs, high rates of medication non adherence, makes it very hard to know what treatments work, and greater cause of non adherence is poor communication
Enhancing Adherence
Good communication; adherence highest when patients receive a clear jargon-free explanation of the etiology diagnosis, and treatment recommendations; higher when patients are encouraged to ask questions, write down recommendations, repeat the instructions; and higher when patient is satisfied with provider relationship.
Lower adherence is associated with
Regiments that must be followed over a long time, regiments that are complex and regimens that interfere with one’s life
Adherence is higher for _______ , lower for _______
medication, lifestyle changes
Avoidant coping
leads to poorer health
Improving communication and reducing nonadeherence teach provides how to communicate reduces non adherence by
Empathy and listening, involving patient in diagnostic and treatment process, communication skills, feedback, cultural competence, appropriate non verbal communication
Training patients to improve communication
Have patients go to an appointment with qs and concerns written down, have patient bring someone with them to advocate on his or her behalf, and manage patient anxiety
Improving Adherence
Reminders, make the experience as easy and pleasant as possible, decrease office wait time, use written, not just verbal instructions, and use pictures, photo novels, symbols, memory aides, use pill boxes with alarms or other aids, use skills training to improve provider communication and patient knowledge, probe for barriers to adherence, stress the most important and actionable components of a treatment, and extract a commitment from the patient
Good communication includes
Patients understanding the treatment regiment, and patients must decide to comply
Universal precautions for medical procedures
Adults and children do better when they know what to expect, providing information about what procedure will feel like enhances coping, self-efficency, and sense of control,information and control-enhancing interventions improve adjustment, and relaxation training and coping skills training can be very beneficial
Complementary and alternative medicine
Set therapies, products and treatments including Yoga, messaging, traditional chinese medication, herbs, and supplements, meds are evaluated for safety and efficiency by the FDA, but herbs supplements are not,and need more research -often placebo effects present
Placebo effect
Inhaling a useless drug improved lung function in children with asthma by 33%, people exposed to fake poison ivy develop rashes, 42% of balding men who took a placebo maintained or increased hair growth, and sham knee surgery reduces pain as much as real knee surgery
Placebo
Any medical procedure that produces an effect because of its therapeutic effect and not its specific nature, whether chemical or physical.
True or false: All treatments, even effective ones have placebo components even psychotherapy
True
True or false: Placebo effects are not real, only in the mind
False
Placebo effects can
Activate the immune system, alter the stress response system, stimulate the release of endorphins,and can be seen on brain scans
What effects the effect of placebos
Provider behavior if provider strongly believes in the treatment, patient characteristics, and situational determinates
Private, fee for-service care
Private physicians paid directly on a visit-by-visit basis
HMO- health maintenance organization
Prepaid financing and delivery system
Preferred-providers organization (PPOs)
A network of affiliated practitioners have agreed to charge, pre established rates for for services, and enrollees in choosing from these practitioners when seeking treatment.
